Healthcare Provider Details

I. General information

NPI: 1275731648
Provider Name (Legal Business Name): PAUL ANSTEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N ROXBURY DR STE 211
BEVERLY HILLS CA
90210-5017
US

IV. Provider business mailing address

436 N ROXBURY DR STE 211
BEVERLY HILLS CA
90210-5017
US

V. Phone/Fax

Practice location:
  • Phone: 310-777-8382
  • Fax: 310-388-0231
Mailing address:
  • Phone: 310-777-8382
  • Fax: 310-388-0231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number38960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: